Eastern State Hospital (Williamsburg, Virginia) Bronte Roberts

Scarificator used to bleed patients.

The commonwealth of Virginia claims that Eastern State Hospital is the oldest psychiatric hospital in the United States having received its first patients on October 12, 1773.  The Colonial legislators passed a bill authorizing the use of an eight-acre site in Williamsburg, Virginia to house “mentally disturbed people who were causing problems in the community” (U.S. National Library of Medicine [NLM], 2017).  The founding of the institution can be traced to a speech given by Francis Fauquier, the Royal Governor of the colony of Virginia.  Fauquier was concerned that persons with mentally illness, devoid of human reasoning, were terrorizing their communities, and that if they could be confined and treated, they would regain their reason.  Unfortunately, by all accounts, this treatment involved chaining and long-term restraints and other cruel practices typical of the time.

The original building  had 24 cells, all designed for security and isolation. Although the structure was topped with a lovely cupola with a very expensive weather vane, Thomas Jefferson derided the building as a "crude misshapen pile". Between 1773 - 1790, only about 20% of inmates were discharged as "cured". For the next  50 years, treatments consisted of restraints, bleedings, blisterings, and plunge baths.

By 1841, the Eastern Lunatic Asylum, as it was then known, housed 125 patients who were under the care of the infamous Dr. John Galt.  Dr. Galt fully embraced the practice of Moral Treatment and introduced the practices of therapeutic activities and talk therapy.  In addition, he believed firmly in the palliative effects of work and the hospital, during his tenure, had a carpentry shop, patient library, game room, and garden (DeVries, 2015).  Also, Dr. Galt, somewhat uncharacteristically for his time, advocated for sound practice based on research, as well as for the equal treatment of African American patients (although the hospital remained segregated until 1968).  He believed that medications should replace physical restraints and dispensed laudanum generously to his patients.  

By the mid 1850s, Dr. Galt’s writings reflect some original thoughts on deinstitutionalization and community-based mental health care.  However, the Civil War devastated the hospital, which was eventually captured by Union troops in 1862.  Dr. Galt took his own life, nine days later, with an overdose of laudanum.

Eastern State Hospital, 1886

In 1885, the 109-year old building burned to the ground.  The new building appears to have been built similar to the original building, but with two additional wings added.  The only mention of Kirkbride in relation to the hospital is references to the contentious relationship between Dr. Galt and Dr. Kirkbride. Kirkbride felt personally attacked by Dr. Galt’s views on architectural “tinkerings” and his claim that asylums were still prison-like (Eastern State Hospital, 2018).  The final modern building was completed in 1985 on the excavated foundation of the original colonial Williamsburg hospital and is composed of four wings, all with sun exposure.  Presently, the hospital treats 300 patients with a staff of over 900 people (Eastern State Hospital, 2018).

Eastern State Hospital, 1985

There does not appear to be easily accessible narratives by patients held in the Eastern Lunatic Asylum in the early years.  Dr. Galt was a prolific author and much of what we know about the golden age of Moral Treatment at Eastern State Hospital is from his writings.

Although Eastern State Hospital appears to have gone through two dark ages (from its conception to the arrival of Dr. Galt and a short period after the Civil War) of cruel and inhumane patient treatment, the hospital has generally maintained a commitment to Moral Treatment even in its modern day mission.  That being said, our institutions still remove the self-sovereignty of people with mental illness.  Reports of paternalistic and patronizing treatments of patients at Eastern State Hospital still exist, and just as Dr. Galt relied on massive doses of laudanum to “treat” his patients, powerful neuroleptics are de rigor. I would never want treatment in any of our institutions and Eastern State Hospital is no exception.  However, if I was involuntarily committed, I believe that Dr. Galt’s hospital from 1840-1860 would have been more pleasant than others.  

References

DeVries, G. (2015). Case study of the Eastern State Hospital as evidence of English influence on American

ideas about mental illness. University of Richmond UR Scholarship Repository, n.p.

Eastern State Hospital. (n.d.). Retrieved from http://www.esh.dbhds.virginia.gov/History.html#library on

July 23, 2018.

U.S. National Library of Medicine. (18 January 2017). Retrieved from

https://www.nlm.nih.gov/hmd/diseases/early.html on July 23, 2018.